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AJNR - American Journal of Neuroradiology

Published ahead of print on March 13, 2008
doi: 10.3174/ajnr.A0921

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Quantitative Differentiation Between Healthy and Disordered Brain Matter in Patients with Neurofibromatosis Type I Using Diffusion Tensor Imaging

S.J.P.M. van Engelen^a, L.C. Krab^b,c, H.A. Moll^b, A. de Goede-Bolder^b, S.M.F. Pluijm^d, C.E. Catsman-Berrevoets^e, Y. Elgersma^c and M.H. Lequin^a

^a Department of Pediatric Radiology, The NF-1 CoRe Team (Cognitive Research Team), Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
^b Department of General Paediatrics, The NF-1 CoRe Team (Cognitive Research Team), Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
^c Department of Neuroscience, The NF-1 CoRe Team (Cognitive Research Team), Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
^d Department of Public Health, The NF-1 CoRe Team (Cognitive Research Team), Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
^e Department of Pediatric Neurology, The NF-1 CoRe Team (Cognitive Research Team), Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands

View larger version (85K): [in this window] [in a new window]   Fig 1. Region-of-interest placement. Transverse b = 0 s/mm2 images of a healthy control (multi-repetition single-shot echo-planar sequence; section thickness of 3 mm with no gap; 25 gradient directions; b = 1000 s/mm2; TR/TE = 15,000/82.1 ms; 1 average; FOV of 240 x 240 mm2; matrix of 128 x 128; voxel size of 1.8 x 1.8 x 3.0 mm3). Circular regions of interest are placed in the CWM (A), the CP and HI (B), the TH (C), the GP (D), and FWM and POWM (E).

View larger version (100K): [in this window] [in a new window]   Fig 2. DTIs of the globus pallidus. Transverse DTIs (multi-repetition single-shot echo-planar sequence; section thickness of 3 mm with no gap; 25 gradient directions; b = 1000 s/mm2; TR/TE = 15,000/82.1 ms; 1 average; FOV of 240 x 240 mm2; matrix of 128 x 128; voxel size of 1.8 x 1.8 x 3.0 mm3). Girl with NF-1 (13 years of age) with a unilateral UBO in the GP. Arrow indicates an area of high intensity on the b = 0 s/mm2 image and high values on the ADC, 2 (lambda 2), and 3 (lambda 3) maps.

View larger version (25K): [in this window] [in a new window]   Fig 3. Mean ADC values. The cohort is divided in 3 groups: NF-1 regions with UBOs (UBO), NF-1 regions with normal-appearing brain matter (NAS), and controls. Mean ADC values for UBOs are higher than those for NAS in all regions (except POWM and FWM where no UBOs were found). Mean ADC values for NAS are significantly higher than those of controls in all regions, except CP. For convenience, the results of the HI area are presented in the same figure as the results of the other regions of interest. HI hyperintensities are presented as UBOs and normal-appearing HI areas as NAS. Significant differences between UBO and NAS are indicated by and between NAS and controls by .

View larger version (21K): [in this window] [in a new window]   Fig 4. FA values. Mean FA values ± SD for UBO, normal-appearing sites (NAS), and controls are plotted for the 7 regions of interest. Few significant differences are found between UBO and NAS, indicated by .

View larger version (22K): [in this window] [in a new window]   Fig 5. Am values. Mean Am values ± SD for UBO, normal-appearing sites (NAS), and controls per regions of interest. Significant differences between UBO and NAS are indicated by and between NAS and controls by .

View larger version (24K): [in this window] [in a new window]   Fig 6. Eigenvalues per region. For UBO, normal-appearing sites (NAS), and controls, mean values for the 3 eigenvalues are plotted for each region. In all regions where UBOs are found, 1, 2, and 3 are higher for UBOs than for NAS and higher for NAS compared with controls. Significant differences between UBO and NAS are indicated by and between NAS and controls by .